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. 2019 Mar 20;9(3):e022695.
doi: 10.1136/bmjopen-2018-022695.

Forty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work-life balance and happiness

J Bryan Sexton  1   2 , Kathryn C Adair  1
Affiliations

Forty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work-life balance and happiness

J Bryan Sexton et al. BMJ Open. .

Abstract

Objectives: High rates of healthcare worker (HCW) burn-out have led many to label it an 'epidemic' urgently requiring interventions. This prospective pilot study examined the efficacy, feasibility and evaluation of the 'Three Good Things' (3GT) intervention for HCWs, and added burn-out and work-life balance to the set of well-being metrics.

Methods: 228 HCWs participated in a prospective, repeated measures study of a web-based 15-day long 3GT intervention. Assessments were collected at baseline and 1, 6 and 12-month post-intervention. The primary measure of efficacy was a derivative of the emotional exhaustion subscale of the Maslach Burnout Inventory. The secondary measures were validated instruments assessing depression symptoms, subjective happiness, and work-life balance. Paired samples t-tests and Cohen's d effect sizes for correlated samples were used to examine the efficacy of the intervention.

Results: 3GT participants exhibited significant improvements from baseline in emotional exhaustion, depression symptoms and happiness at 1 month, 6 months and 12 months, and in work-life balance at 1 month and 6 months (effect sizes 0.16-0.52). Exploratory subgroup analyses of participants meeting 'concerning' criteria at baseline revealed even larger effects at all assessment points (0.55-1.57). Attrition rates were similar to prior 3GT interventions.

Conclusion: 3GT appears a promising low-cost and brief intervention for improving HCW well-being.

Ethics and dissemination: This study is approved by the Institutional Review Board of Duke University Health System (Pro00063703). All participants are required to give their informed consent prior to any study procedure.

Keywords: burnout; burnout intervention; depression; happiness; three good things; work-life balance.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Well-being metrics at baseline, 1, 6 and 12-month follow-up. For demonstration purposes, all variables were scaled 0–100 in this graph. Burn-out was already scaled 0–100, depression scores (response range 0–30) were multiplied by 3.33, WLB scores (response range 1–4) were subtracted by 1 and multiplied by 33.33 and Subjective Happiness Scores (response range 1–7) were subtracted by 1 and multiplied by 16.66. WLB, work–life balance.
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